This study is designed to measure the effectiveness of computer-assisted medical audit in improving drug prescribing practices in an emergency service setting. The care of patients treated for soft tissue injuries in three hospital emergency departments will be concurrently reviewed during a one-year period. The audit will be based upon a clinical algorithm for laceration care previously developed by the principal investigators and a panel of expert clinicians. This algorithm includes recommendations concerning the use of topical, oral, intramuscular, and intravenous antibiotics, local anaesthetics, and tetanus toxid and hyperimmune globulin. Providers in the three hospitals will receive daily case audit reports indicating any instances of deviation from these recommendations, and will be asked to explain the reasons for such deviations. The basic hypothesis is that this rapid response educational feedback system, which emphasizes the logical basis for treatment decisions through detailed case audit reports given to the provider, will bring about improvements in drug prescribing behavior. This hypothesis will be tested by observing the deviation rates in each of the three study sites. If these rates decline significantly during the study period, this will provide evidence that the audit is effective in altering prescriber behavior. The study will also address the following subordinate questions: (1) Do changes in prescriber behavior persist beyond the period of audit, and (2) What is the relative effectiveness of the audit as a function of the delay between a particular episode of patient care and the provider's receipt of the case audit repoot. Because the three emergency departments differ with respect to size, affiliation, and type of medical staff, it is possible that the system may not be uniformly effective. The data will therefore be analyzed separtely for each institution, as well as in aggregate. If significant inter-hospital differences are observed, this result will be used to suggest further, more extensive studies concerned with maximizing the audit's effectiveness in different settings.